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Waist and Hip Measurements
There are a number of factors that can help you estimate your risk for health problems like heart disease, stroke, high blood pressure and diabetes. I have discussed a number of these in this column and there is information throughout the Dr. Gourmet site in The health of it all… sidebars.

What does Waist to Hip ratio have to do with Body Mass Index?
As a physician I look to have an idea of how my patient's health might be overall. I am looking for certain risk factors for disease and the research has come to show that being overweight or obese can be an issue. In looking at my patient's weight I want to have a guide of what a healthy weight is but we now also know that the distribution of the weight on the body is an important factor.

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Are you an apple, or a pear?

As part of a large study researchers
have shown that the Waist to Hip Ratio (WHR) is probably a more important
predictor of heart attack than Body Mass Index (BMI). The WHR is an key
measurement that I use in my practice to determine a patient’s risk of
future illness and is very simple to do. It is calculated by dividing the
measurement around your waist by the measurement around your hips.

When weight is greater around the waist than the hips we often call this
an "apple" shape. Those with more weight in the hips are considered
to be "pear" shaped. This measure is different from the BMI,
which has long been used as the standard tool for measuring overweight
and obese persons.

The INTERHEART study compared over 15,000 people at the time of their
first heart attack with a similar number of healthy people who had not
had a heart attack (The Lancet 2005:366;1640-1649). Researchers
used the data to look at both WHR and BMI. This was a study that spanned
many cultures, including China, Southeast Asia, Europe, North America,
the Middle East, Australia and New Zealand. Across these cultures, as the
BMI increased, the risk for heart attack also increased.

When the researchers adjusted for other risk factors this relationship
was not as strong, however. By comparing BMI with such things as smoking,
abnormal cholesterol profile, high blood pressure, diabetes, stress, a
lack of frequent consumption of fruits and vegetables as well as a lack
of daily exercise the risk for heart attack was not as strongly predicted
by Body Mass Index. When they looked at the same comparisons using the
Waist to Hip Ratio the scientists found that the risk of heart attack increased
with increasing WHR whether a person had one of the eight INTERHEART risk
factors or not.

What this means for you

Weight is important, but it is the distribution
of weight that appears to be just as important to preventing heart
attack. Check both your Body
Mass Index and Waist
to Hip Ratio to see where you stand.